Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Aortic stenosis subtypes: impact on TAVR outcomes
Session:
Painel 11 - Cardiologia Intervenção 4
Speaker:
Pedro Ribeiro Queirós
Congress:
CPC 2020
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Posters
FP Number:
---
Authors:
Pedro Ribeiro Queirós; Nuno Dias Ferreira; Cláudio Guerreiro; Gualter Santos Silva; Mariana Ribeiro Da Silva; Cátia Serena; Pedro Gonçalves Teixeira; Pedro Braga; Ana Raquel Barbosa
Abstract
<p><strong>Introduction</strong></p> <p>Severe aortic stenosis (AS) patients can be divided into different groups according to their hemodynamic characteristics and left ventricular ejection (EF) fraction. The differences in outcomes of AS patients treated with TAVR between these groups remain controversial. </p> <p><strong>Aim</strong></p> <p>To characterise the different AS subtypes and determine their impact on periprocedural and 1-year outcomes after TAVR.</p> <p><strong>Methods</strong></p> <p>Four hundred and seventy one (471) consecutive severe AS patients who underwent TAVR at our institution from 2007 to 2018 were analysed. Groups were defined according to mean aortic gradient (MAG), indexed stroke volume (iSV) and left ventricular ejection fraction (LVEF): high-gradient AS (HGAS: MAG ≥40mmHg); low-flow low-gradient AS with reduced EF (LFLGrEF, MAG <40mmHg, iSV ≤35mL/m² and LVEF <50%); paradoxical low-flow low-gradient AS (PLFLG, MAG <40mmHg, iSV ≤35mL/m² and LVEF ≥50%); low-gradient normal-flow AS (LGNF, MAG <40mmHg, iSV ≥35mL/m²). The groups were compared according to VARC2 defined outcomes and 1-year all-cause mortality.</p> <p><strong>Results</strong></p> <p>Three hundred and sixty (n=360, 76,4%) patients had HGAS, 38 (10,6%) LFLGrEF , 36 (10,0%) PLFLG, and 37 LGNF (10,3%). Mean age was 79,6 ± 7,8 with no differences between groups. LFLGrEF patients were more likely to be male (71%, p<0.05), had higher prevalence of coronary artery disease (76,3% vs. HGAS 51,1% vs. PLFLG 64,7% vs. LGNF 50,0%, p<0.05), higher mean surgical risk (EuroscoreII score 8.4 ± 5.1 vs. HGAS 5.3 ± 4.9 vs. PLFLG 7.9 ± 9.3 vs. LGNF 5.4 ± 3.7, p<0.01), lower LVEF (36,7%, vs. HGAS 54,0%, vs. PLFLG 56,6% vs. LGNF 52,0%, p<0.001) and higher left ventricular end diastolic diameter (56.2mm, vs. HGAS 49.6 vs. PLFLG 50.7 vs. LGNF 50.5, p<0.01). PLFLG patients had higher prevalence of atrial fibrillation (56,0%, vs. HGAS 27,1% vs. LFLGrEF 51,4% vs. LGNF 36,1%). HGAS patients had smaller aortic valve area (0.62cm² vs. LFLGrEF 0.69cm² vs. PLFLG 0.68cm² vs. LGNF 0.77cm², p <0.001). No differences between the groups were observed regarding procedural success (HGAS 99,7% vs. LFLGrEF 97,4% vs. PLFLG 100% vs. LGNF 97,3%, p=0.12) as well as 1-year mortality (HGAS 13,1% vs. LFLGrEF 13,1% vs. PLFLG 8,3% vs. LGNF 10,8%, p=0.85) and safety (HGAS 58,6% vs. LFLGrEF 47,4% vs. PLFLG 72,2% vs. LGNF 67,6%, p=0.12). </p> <p><strong>Conclusion</strong></p> <p>The majority of patients treated with TAVR had classical HGAS. LFLGrEF represented a smaller group, with a particularly high risk profile. Nevertheless, these differences did not translate into worse procedural and 1-year outcomes, and in fact they seemed to derive similar benefit.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site